I guess one plant only needs to be better (more efficacy, without more side-effects)in one scenario to prove that such a possiblity exists.

Natural complex substances are often attributed “superior” effects to constituent chemicals because of synergy, a concept not unique to plant medicine. I find it curious that almost all conventional medicines are single chemicals when synergy is such an appealing notion – more bang for your buck! Of course there are a few mixed drugs, and not all mixtures are synergistic.

Synergy in the action of plants has been demonstrated in three distinct ways:

1 Synergy between herbal constituents in one plant
2 Synergy between herbs
3 Synergy between a herbs and a conventional medicine

Here is the abstract from a 2001 review

Here is the abstract from a review of synergy in plant medicines:

Synergistic interactions are of vital importance in phytomedicines, to explain difficulties in always isolating a single active ingredient, and explain the efficacy of apparently low doses of active constituents in a herbal product. This concept, that a whole or partially purified extract of a plant offers advantages over a single isolated ingredient, also underpins the philosophy of herbal medicine. Evidence to support the occurrence of synergy in within phytomedicines is now accumulating and is reviewed here. Synergistic interactions are documented for constituents within a total extract of a single herb, as well as between different herbs in a formulation. Positive and negative aspects of interactions are discussed together with the methods used to identify and measure synergy. The evidence is divided into experimental, in vitro instances, as well as clinical examples where available. Herbs discussed include Ginkgo biloba, Piper methysticum (Kava-Kava), Glycyrrhiza glabra, Hypericum perforatum, Valeriana officinalis, Cannabis sativa, Salix alba and others.

Williamson EM 2001 Synergy and other interactions in phytomedicines. Phytomedicine 8(5):401-409

Looking at more recent work, here is one that finds synergy between a plant’s constituents:

Kan WL, Cho CH, Rudd JA, Lin G 2008 Study of the anti-proliferative effects and synergy of phthalides from Angelica sinensis on colon cancer cells. Journal of Ethnopharmacology 120(1):36-43

Here are two that find synergy between plants:

Adams LS, Seeram NP, Hardy ML, Carpenter C, Heber D 2006 Analysis of the interactions of botanical extract combinations against the viability of prostate cancer cell lines. Evidence Based Complementary & Alternative Medicine 3(1):117-124

Gao JL, He TC, Li YB, Wang YT 2009 A traditional Chinese medicine formulation consisting of Rhizoma Corydalis and Rhizoma Curcumae exerts synergistic anti-tumor activity. Oncology Reports 22(5):1077-1083

I have examples of the third type of synergy, but I guess they would not address your argument.

Not much clinical evidence here. And, on that note, I presume you regard in vitro or animal evidence of toxicity with the same degree of circumspection that you reserve for in vitro or animal evidence of a plant’s efficacy?

Aspirin is acetylsalicylic acid and is a synthetic derivative of salicylic acid.

Salicylic acid and acetylsalicylic acid are different compounds and have different effects on the body – comparing them is like comparing apples and oranges (like I tried to say earlier…)

Nope, many drugs are just extracts form plants. As far as I know, aspirin is just synthesised salicin.

We were trying to discuss whether there is any merit to administering WHOLE herbs, as opposed to drugs extracted from herbs, OR their synthesised equivalents.

I thought that was the point: comparison of the active herb ingedient vs the active ingedient in aspirin.

To get some sort of answer to your question, you need the active ingredient in the herb to exceeed the quantity of active ingredient in the drug and the herb to be safe and the drug to have side-effects. Or the converse (herb is only safe at low dose of active ingredient).

“Perhaps the intestinal bleeding you mention is from prolonged use? ” I’m sure that is so. But the article did state that this is the most significant side-effect.

Yes Robert, that may be so also.

I only posted for interest, conclusive results are going to be hard to find.

The difference in dosage and efficacy may not be completely comparable.

The aspirin I have in my cupboard is in 300mg capsules, and up to three may be taken at once, up to four times a day. Perhaps the intestinal bleeding you mention is from prolonged use?

If white willow bark is used whole, say as a tea, then several thousand milligrams of whole herb are used. The advice is to have no more than three cups a day, as it is not possible to say how much salicin is in the actual herb.

It’s all too vague to really compare, but the safe dose of salicin you quoted has nothing to do with what’s in white willow as a whole, as it is only one chemical extracted from the plant being discussed there.

This paper (page 330s) says that there was a small but significant increase in gastric bleeding at doses as low as 75mg/d of aspirin.
www.chestjournal.org/cgi/reprint/102/4/327S.pdf

I don’t know what the relationship between salicin and aspirin is, but at face value, it would appear to be the other components of white willow that protect. (but white willow can have side-effects too).

I’m not a fan of any approach to knowledge that says, “we can’t know everything, therefore don’t bother trying to know anything,” nor am I particularly keen on an approach that says, “You don’t know which is best, therefore my way is best.”

However, I was attempting to answer Ben’s point, which was, “Until a herbal practitioner can show that giving a whole plant instead of an extract really is better, they’re making stuff up when they make those claims.”

My friend suggested that Hypericum was just such an example. So I trawled through every study I could find. What I discovered were studies that a) show the whole plant works, and b) studies that show parts of the plant work; but no studies looking to see whether the whole plant works better than parts of the plant alone, or in what circumstances this would be true.

Had I found such a study, I would also have wanted to ask, can we also test a *designed* combination of constituents against a naturally occurring combination of constituents, to see if we cannot improve upon the combo found in nature.

www.hypericum.com/

Have fun,

For sure, Hypericum contains a vast array of compounds capable of exerting a serotonergic or dopaminergic effect upon the nervous systems of humans or animals, and some studies do suggest that the compound hyperforin is especially active in these roles. While it must be the case that a whole-herb treatment will include action by many or all of these compounds, I have been completely unable to uncover any research that compares the efficacy of compounds to each other or combinations of the same.

Certainly these things are amenable to research, and the individual effects of certain compounds has been studied, as has the efficacy of the whole herb when compared to standard pharmaceutical treatments. And yet, there seems to be nothing to support or refute the claim that a whole herb treatment has greater efficacy, or is preferable on some other grounds, when compared to isolated compounds. Neither does there seem to be anything to suggest that a designed combination of compounds would necessarily be inferior to a naturally occurring one.

I tried, but I just don’t think the research has been done.

I’ve been pressing my herbalist friend on evidence for the concept of “synergy” but sadly he seems too busy to provide me with actual links to studies, which he is adamant do exist.

The example he keeps raising it that of St. John’s Wort. This, he says, is demonstrably effective as an SSRI (and has a similar influence on dopamine as it does on sertonin) but he maintains that medical science, despite having proved this, does not now how or why it works. According to him, no extract of the plant functions as an SSRI, only the mysterious combination of chemicals in the whole herb.

I am wondering why capsules are sold with a standardised level of hepericin in this case.

What are you thoughts on this? My research skills are not awesome, but I do intend to try and find whatever studies might be available.

Meanwhile, I did listen to a Podcast from Sciantific American last month, on which an ethnobotanist gave a fascinating description of his job, liaising between drug companies and indigenous peoples, using their tribal lore to pinpoint potential combinations of herbs that might have synergistic effects amenable to research. This seemed like rather a turn around to me, so it caught my attention.

You can hear that here:
www.sciam.com/podcast/podcast.mp3?e_id=1E5B6D81-E7F2-99DF-3A1431B73A41F3B9&ref=p_sciam

He’s an odd looking, unclassifiable alien creature, with blue fur, bug eyes and a long crooked nose. He takes pride in his uniqueness, and he enjoys everything that he does — no matter how painful or ill-advised it may be.